Sleep Archive

A few inexpensive changes in the home can lead to fewer injuries from falls each year.

Falls are the leading cause of injuries among older adults, sending more than two million people to the emergency department each year. Falls often result in brain injuries, hip fractures, immobility, and even early death. And many of the fall hazards are right in our own homes. "Anything that might trip a person is going to increase the risk of a fall. People with a balance disorder are often unable to recover when they trip because they lack the agility and coordination to do so," says Dr. Steven Rauch, a hearing and balance expert at Harvard-affiliated Massachusetts Eye and Ear Infirmary.

But most falls are preventable. In fact, a study published in 2014 in The Lancet showed that inexpensive fixes at home are associated with 26% fewer injuries from falls each year. The following modifications made a difference for study participants.

Here's how to get the most out of physical therapy and cardiac rehab.

A healthy person needs 30 to 50 ounces of fluid per day.

More evidence that plant-based diets can help you stay healthy.

In particular, nuts and peanuts are getting attention for their heart benefits. A study published in JAMA Internal Medicine on March 2, 2015, found that among 72,000 Americans in the southern United States and 135,000 people in China, eating peanuts (a legume) and nuts (such as almonds and walnuts) was associated with a reduction of 17% to 21% in the risk of dying from any cause, especially heart disease. This study was not a randomized trial, and therefore it cannot prove that a regular diet of nuts has such positive health effects. However, two previous randomized trials did find that such a diet was heart-healthy. "Nuts and peanuts are rich in unsaturated fatty acids, known for reducing inflammation, improving blood vessel function, and lowering LDL cholesterol," says Debbie Krivitsky, director of clinical nutrition at the Cardiovascular Disease Prevention Center at Harvard-affiliated Massachusetts General Hospital. The American Heart Association recommends eating four servings of unsalted, unoiled nuts per week. A serving size is a small handful (1.5 ounces) of whole nuts or 2 tablespoons of nut butter.

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Q. I have pelvic organ prolapse and work out at the gym almost every day. Are there any forms of exercise that will make my situation worse?

A. Pelvic organ prolapse results from weakened muscles and ligaments of the pelvic floor, which allow your bladder or uterus to drop and press against the walls of the vagina. You didn't say what type of exercise you do at the gym, but there are a few you should avoid—lifting heavy weights, especially over shoulder height; high-impact aerobic activities involving jumping or hopping; and sit-ups. You should check with a trainer at the gym to see how you can modify strength training, core exercises, and aerobics to reduce stress on your pelvic floor.

Q. The article in your December 2014 issue about women's waistlines expanding the past few years intrigued me, because I have experienced an increase, and I have not gained weight. My theory is that the styles of the past few years—pants riding low on the hips, no belts at the waist, and loose shirts—may have caused my waist to increase from 24 to 25½ inches. I am 59 years old, so it also could be aging in general, but I still think the belted styles kept women smaller. Am I right?

A. There is no evidence that the physical effect of wearing a belt influences waist circumference. At best, wearing a belt is one way to keep tabs on your waistline. While having to loosen their belt a notch may drive some women to re-examine their diet and exercise routines, it doesn't sound as if you need to do that. I think your alternative explanation that aging is responsible is more likely to be true.

As we reported in March, sleep apnea and other sleep breathing problems are associated with the development of dementia. Now a study published online April 15, 2015, by Neurology finds that sleep breathing problems are associated with an earlier onset of the decline in thinking skills.

Researchers analyzed the medical histories of about 2,500 people ages 55 to 90 and found that people with sleep breathing problems were diagnosed with mild cognitive impairment (a decline in thinking skills) an average of 10 years earlier than people who didn't have those problems. The encouraging news: people who treated their sleep breathing problems with a continuous positive airway pressure (CPAP) machine were diagnosed with mild cognitive impairment about 10 years later than people whose problems were not treated. The study doesn't prove a cause-and-effect relationship, but it does offer hope. "CPAP improves the quality of sleep in people with sleep-disordered breathing. Healthy sleep is an important time for our brains to accomplish critical 'housekeeping' tasks. One of these tasks is clearing beta-amyloid, one of the main proteins associated with Alzheimer's disease," says Dr. Scott McGinnis, an instructor in neurology at Harvard Medical School.

Don't be misled by well-intentioned advice. Some processed foods offer nutritional value and convenience.

Nutrition gurus often urge us to spurn processed foods in favor of whole ones. But not all processed foods are necessarily bad. "Most food needs to go through some sort of processing for it to even be edible and digestible," says Stacey Nelson, a registered dietitian and manager of clinical nutrition at Harvard-affiliated Massachusetts General Hospital. "The minute you cook something, you are processing it."

An ingrown toenail is one of the most common sources of foot pain. Although it's usually just a nuisance, it can be a serious problem for anyone with diabetes or circulatory difficulties.

An ingrown toenail develops when the side of the nail digs into the skin. This can lead to pain, irritation, swelling, and redness. The big toe is most often affected, although no toe is immune. The problem usually develops because the nails have not been trimmed properly. Overly tight shoes may also be a factor. Some people have an inherited tendency to develop the problem.